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Consent to Release Information

Authorize DrugEval.com to send your substance abuse evaluation report to a person or organization you specify.

To fill out the Consent to Release Information form, provide the following:

  • Your details: full name, email, and date of birth.
  • Recipient details: the contact for who should receive your report—either a fax number, email address, or mailing address.

After you submit the form, we will send the report using the method you choose: fax, email, or mail.

Note: Please allow up to 24 business hours for requests to release information to be processed.

You may revoke this authorization at any time by submitting a request via Submit Ticket. Revocation does not apply to information already released.

  • What we release: your substance abuse evaluation report only, unless you specify otherwise.
  • Who receives it: the person or organization you list on the form.
  • How to revoke consent: submit a written request. Revocation will not affect information already released.
  • We may verify your identity before releasing information.
  • Processing time: up to 24 business hours after form submission.
  • Email/fax: once sent, delivery to the recipient’s systems is outside our control. We will re-attempt if we receive a failure notice.
  • Mail: allow additional time for postal delivery.
  • Updates: if recipient info changes, please contact us to update your request.
Can you send my report to more than one recipient?

Yes. Add each recipient (fax, email, or mailing address). Additional processing time may apply.

Can I change or cancel my request after submitting?

If we have not yet sent the report, we can update or cancel the request upon your written notification.

Is typing my name a valid signature?

Yes. By submitting the form, you consent to use an electronic signature and electronic records for this authorization.

Need help completing this form or another accessible format? Submit a Support Ticket.

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